| NPI | 1700178209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101262577) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 50611) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2022-07-21 |